The Green Medicines

The men have to sometimes rely on the medicine or some help to give the pleasure to their partners in sexual relationship. The use of the sexual enhancement medicines has increased and it has become a separate industry or category in the medicinal products. The synthetic medicines have far reaching impacts on the male health and hence the people are now using natural and herbal ways to improve their sexuality to give pleasure to their female. The natural medicines are cheap and have no side effect on human health. Therefore, the use of the herbal medicine has tremendously risen up during this decade.

The herbal products and medicine are very popular and there are a lot number of persons who have tried these medicines and got the results. You can see even a few examples from your local area. However, the doctors don’t believe it and they regard only the man- made medicinal products as the performance booster ignoring the side effects.

The points mentioned below will explain the use of these herbs to enhance the sexual activity in men as safe as possible.

1. Some herbal products are usually scam and therefore you should have a look on the market to see that products really works or is just a fraud. Check the views of the public out to see what they have to say. This is especially important if people have already used them personally.

2. Before buying any herbal or medicinal product, you should read the manual and the ingredients carefully. As the product can be stronger than your requirements and this is bad for your health. Try to avoid the herbs that are known for some side effects on the male health after the intercourse.

3. If your partner is fully satisfied with the sexual ability you have then do not use such treatments or medicines at all and rely on your natural vigor to satisfy her. There is no need to buy expensive herbal medicines and increase your financial burden. You can do regular exercise and the perfect diet will boost your power up.

4. Your diet should be according to the proper recommendation that what you should eat with the herbal medicine to get the most out of it. You can also visit various websites to learn more about the sexual enhancement and read about various special foods. Just be careful that the website is not a front for an advertisement of the product itself. Instead, you want honest reviews.

Go ahead and adopt the green!

Health Care Reform – Why Are People So Worked Up?

Why are Americans so worked up about health care reform? Statements such as “don’t touch my Medicare” or “everyone should have access to state of the art health care irrespective of cost” are in my opinion uninformed and visceral responses that indicate a poor understanding of our health care system’s history, its current and future resources and the funding challenges that America faces going forward. While we all wonder how the health care system has reached what some refer to as a crisis stage. Let’s try to take some of the emotion out of the debate by briefly examining how health care in this country emerged and how that has formed our thinking and culture about health care. With that as a foundation let’s look at the pros and cons of the Obama administration health care reform proposals and let’s look at the concepts put forth by the Republicans?

Access to state of the art health care services is something we can all agree would be a good thing for this country. Experiencing a serious illness is one of life’s major challenges and to face it without the means to pay for it is positively frightening. But as we shall see, once we know the facts, we will find that achieving this goal will not be easy without our individual contribution.

These are the themes I will touch on to try to make some sense out of what is happening to American health care and the steps we can personally take to make things better.

  • A recent history of American health care – what has driven the costs so high?
  • Key elements of the Obama health care plan
  • The Republican view of health care – free market competition
  • Universal access to state of the art health care – a worthy goal but not easy to achieve
  • what can we do?

First, let’s get a little historical perspective on American health care. This is not intended to be an exhausted look into that history but it will give us an appreciation of how the health care system and our expectations for it developed. What drove costs higher and higher?

To begin, let’s turn to the American civil war. In that war, dated tactics and the carnage inflicted by modern weapons of the era combined to cause ghastly results. Not generally known is that most of the deaths on both sides of that war were not the result of actual combat but to what happened after a battlefield wound was inflicted. To begin with, evacuation of the wounded moved at a snail’s pace and this caused severe delays in treating the wounded. Secondly, many wounds were subjected to wound care, related surgeries and/or amputations of the affected limbs and this often resulted in the onset of massive infection. So you might survive a battle wound only to die at the hands of medical care providers who although well-intentioned, their interventions were often quite lethal. High death tolls can also be ascribed to everyday sicknesses and diseases in a time when no antibiotics existed. In total something like 600,000 deaths occurred from all causes, over 2% of the U.S. population at the time!

Let’s skip to the first half of the 20th century for some additional perspective and to bring us up to more modern times. After the civil war there were steady improvements in American medicine in both the understanding and treatment of certain diseases, new surgical techniques and in physician education and training. But for the most part the best that doctors could offer their patients was a “wait and see” approach. Medicine could handle bone fractures and increasingly attempt risky surgeries (now largely performed in sterile surgical environments) but medicines were not yet available to handle serious illnesses. The majority of deaths remained the result of untreatable conditions such as tuberculosis, pneumonia, scarlet fever and measles and/or related complications. Doctors were increasingly aware of heart and vascular conditions, and cancer but they had almost nothing with which to treat these conditions.

This very basic review of American medical history helps us to understand that until quite recently (around the 1950’s) we had virtually no technologies with which to treat serious or even minor ailments. Here is a critical point we need to understand; “nothing to treat you with means that visits to the doctor if at all were relegated to emergencies so in such a scenario costs are curtailed. The simple fact is that there was little for doctors to offer and therefore virtually nothing to drive health care spending. A second factor holding down costs was that medical treatments that were provided were paid for out-of-pocket, meaning by way of an individuals personal resources. There was no such thing as health insurance and certainly not health insurance paid by an employer. Except for the very destitute who were lucky to find their way into a charity hospital, health care costs were the responsibility of the individual.

What does health care insurance have to do with health care costs? Its impact on health care costs has been, and remains to this day, absolutely enormous. When health insurance for individuals and families emerged as a means for corporations to escape wage freezes and to attract and retain employees after World War II, almost overnight a great pool of money became available to pay for health care. Money, as a result of the availability of billions of dollars from health insurance pools, encouraged an innovative America to increase medical research efforts. More Americans became insured not only through private, employer sponsored health insurance but through increased government funding that created Medicare and Medicaid (1965). In addition funding became available for expanded veterans health care benefits. Finding a cure for almost anything has consequently become very lucrative. This is also the primary reason for the vast array of treatments we have available today.

I do not wish to convey that medical innovations are a bad thing. Think of the tens of millions of lives that have been saved, extended, enhanced and made more productive as a result. But with a funding source grown to its current magnitude (hundreds of billions of dollars annually) upward pressure on health care costs are inevitable. Doctor’s offer and most of us demand and get access to the latest available health care technology in the form of pharmaceuticals, medical devices, diagnostic tools and surgical procedures. So the result is that there is more health care to spend our money on and until very recently most of us were insured and the costs were largely covered by a third-party (government, employers). Add an insatiable and unrealistic public demand for access and treatment and we have the “perfect storm” for higher and higher health care costs. And by and large the storm is only intensifying.

At this point, let’s turn to the key questions that will lead us into a review and hopefully a better understanding of the health care reform proposals in the news today. Is the current trajectory of U.S. health care spending sustainable? Can America maintain its world competitiveness when 16%, heading for 20% of our gross national product is being spent on health care? What are the other industrialized countries spending on health care and is it even close to these numbers? When we add politics and an election year to the debate, information to help us answer these questions become critical. We need to spend some effort in understanding health care and sorting out how we think about it. Properly armed we can more intelligently determine whether certain health care proposals might solve or worsen some of these problems. What can be done about the challenges? How can we as individuals contribute to the solutions?

The Obama health care plan is complex for sure – I have never seen a health care plan that isn’t. But through a variety of programs his plan attempts to deal with a) increasing the number of American that are covered by adequate insurance (almost 50 million are not), and b) managing costs in such a manner that quality and our access to health care is not adversely affected. Republicans seek to achieve these same basic and broad goals, but their approach is proposed as being more market driven than government driven. Let’s look at what the Obama plan does to accomplish the two objectives above. Remember, by the way, that his plan was passed by congress, and begins to seriously kick-in starting in 2014. So this is the direction we are currently taking as we attempt to reform health care.

  1. Through insurance exchanges and an expansion of Medicaid,the Obama plan dramatically expands the number of Americans that will be covered by health insurance.
  2. To cover the cost of this expansion the plan requires everyone to have health insurance with a penalty to be paid if we don’t comply. It will purportedly send money to the states to cover those individuals added to state-based Medicaid programs.
  3. To cover the added costs there were a number of new taxes introduced, one being a 2.5% tax on new medical technologies and another increases taxes on interest and dividend income for wealthier Americans.
  4. The Obama plan also uses concepts such as evidence-based medicine, accountable care organizations, comparative effectiveness research and reduced reimbursement to health care providers (doctors and hospitals) to control costs.

The insurance mandate covered by points 1 and 2 above is a worthy goal and most industrialized countries outside of the U.S. provide “free” (paid for by rather high individual and corporate taxes) health care to most if not all of their citizens. It is important to note, however, that there are a number of restrictions for which many Americans would be culturally unprepared. Here is the primary controversial aspect of the Obama plan, the insurance mandate. The U.S. Supreme Court recently decided to hear arguments as to the constitutionality of the health insurance mandate as a result of a petition by 26 states attorney’s general that congress exceeded its authority under the commerce clause of the U.S. constitution by passing this element of the plan. The problem is that if the Supreme Court should rule against the mandate, it is generally believed that the Obama plan as we know it is doomed. This is because its major goal of providing health insurance to all would be severely limited if not terminated altogether by such a decision.

As you would guess, the taxes covered by point 3 above are rather unpopular with those entities and individuals that have to pay them. Medical device companies, pharmaceutical companies, hospitals, doctors and insurance companies all had to “give up” something that would either create new revenue or would reduce costs within their spheres of control. As an example, Stryker Corporation, a large medical device company, recently announced at least a 1,000 employee reduction in part to cover these new fees. This is being experienced by other medical device companies and pharmaceutical companies as well. The reduction in good paying jobs in these sectors and in the hospital sector may rise as former cost structures will have to be dealt with in order to accommodate the reduced rate of reimbursement to hospitals. Over the next ten years some estimates put the cost reductions to hospitals and physicians at half a trillion dollars and this will flow directly to and affect the companies that supply hospitals and doctors with the latest medical technologies. None of this is to say that efficiencies will not be realized by these changes or that other jobs will in turn be created but this will represent painful change for a while. It helps us to understand that health care reform does have an effect both positive and negative.

Finally, the Obama plan seeks to change the way medical decisions are made. While clinical and basic research underpins almost everything done in medicine today, doctors are creatures of habit like the rest of us and their training and day-to-day experiences dictate to a great extent how they go about diagnosing and treating our conditions. Enter the concept of evidence-based medicine and comparative effectiveness research. Both of these seek to develop and utilize data bases from electronic health records and other sources to give better and more timely information and feedback to physicians as to the outcomes and costs of the treatments they are providing. There is great waste in health care today, estimated at perhaps a third of an over 2 trillion dollar health care spend annually. Imagine the savings that are possible from a reduction in unnecessary test and procedures that do not compare favorably with health care interventions that are better documented as effective. Now the Republicans and others don’t generally like these ideas as they tend to characterize them as “big government control” of your and my health care. But to be fair, regardless of their political persuasions, most people who understand health care at all, know that better data for the purposes described above will be crucial to getting health care efficiencies, patient safety and costs headed in the right direction.

A brief review of how Republicans and more conservative individuals think about health care reform. I believe they would agree that costs must come under control and that more, not fewer Americans should have access to health care regardless of their ability to pay. But the main difference is that these folks see market forces and competition as the way to creating the cost reductions and efficiencies we need. There are a number of ideas with regard to driving more competition among health insurance companies and health care providers (doctors and hospitals) so that the consumer would begin to drive cost down by the choices we make. This works in many sectors of our economy but this formula has shown that improvements are illusive when applied to health care. Primarily the problem is that health care choices are difficult even for those who understand it and are connected. The general population, however, is not so informed and besides we have all been brought up to “go to the doctor” when we feel it is necessary and we also have a cultural heritage that has engendered within most of us the feeling that health care is something that is just there and there really isn’t any reason not to access it for whatever the reason and worse we all feel that there is nothing we can do to affect its costs to insure its availability to those with serious problems.

OK, this article was not intended to be an exhaustive study as I needed to keep it short in an attempt to hold my audience’s attention and to leave some room for discussing what we can do contribute mightily to solving some of the problems. First we must understand that the dollars available for health care are not limitless. Any changes that are put in place to provide better insurance coverage and access to care will cost more. And somehow we have to find the revenues to pay for these changes. At the same time we have to pay less for medical treatments and procedures and do something to restrict the availability of unproven or poorly documented treatments as we are the highest cost health care system in the world and don’t necessarily have the best results in terms of longevity or avoiding chronic diseases much earlier than necessary.

I believe that we need a revolutionary change in the way we think about health care, its availability, its costs and who pays for it. And if you think I am about to say we should arbitrarily and drastically reduce spending on health care you would be wrong. Here it is fellow citizens – health care spending needs to be preserved and protected for those who need it. And to free up these dollars those of us who don’t need it or can delay it or avoid it need to act. First, we need to convince our politicians that this country needs sustained public education with regard to the value of preventive health strategies. This should be a top priority and it has worked to reduce the number of U.S. smokers for example. If prevention were to take hold, it is reasonable to assume that those needing health care for the myriad of life style engendered chronic diseases would decrease dramatically. Millions of Americans are experiencing these diseases far earlier than in decades past and much of this is due to poor life style choices. This change alone would free up plenty of money to handle the health care costs of those in dire need of treatment, whether due to an acute emergency or chronic condition.

Let’s go deeper on the first issue. Most of us refuse do something about implementing basic wellness strategies into our daily lives. We don’t exercise but we offer a lot of excuses. We don’t eat right but we offer a lot of excuses. We smoke and/or we drink alcohol to excess and we offer a lot of excuses as to why we can’t do anything about managing these known to be destructive personal health habits. We don’t take advantage of preventive health check-ups that look at blood pressure, cholesterol readings and body weight but we offer a lot of excuses. In short we neglect these things and the result is that we succumb much earlier than necessary to chronic diseases like heart problems, diabetes and high blood pressure. We wind up accessing doctors for these and more routine matters because “health care is there” and somehow we think we have no responsibility for reducing our demand on it.

It is difficult for us to listen to these truths but easy to blame the sick. Maybe they should take better care of themselves! Well, that might be true or maybe they have a genetic condition and they have become among the unfortunate through absolutely no fault of their own. But the point is that you and I can implement personalized preventive disease measures as a way of dramatically improving health care access for others while reducing its costs. It is far better to be productive by doing something we can control then shifting the blame.

There are a huge number of free web sites available that can steer us to a more healthful life style. A soon as you can, “Google” “preventive health care strategies”, look up your local hospital’s web site and you will find more than enough help to get you started. Finally, there is a lot to think about here and I have tried to outline the challenges but also the very powerful effect we could have on preserving the best of America’s health care system now and into the future. I am anxious to hear from you and until then – take charge and increase your chances for good health while making sure that health care is there when we need it.

Secrets for Success in the Current Healthcare Climate: Q and A With UW Medicine CEO Paul G Ramsey

For the past 20 years, UW Medicine has received top ratings from U.S. News & World Report for its clinical, education and research programs. However, even one of the nation’s leading academic healthcare systems feels the current economic strain and pressure of national healthcare reform. It can be a challenge to improve healthcare quality, safety and access while also controlling and reducing costs.

Paul G. Ramsey, MD, CEO of UW Medicine, executive vice president for medical affairs and dean of the school of medicine at the University of Washington in Seattle, discusses UW Medicine’s current goals as well as the system’s “secrets for success” in the current healthcare climate – measurements and metrics, teamwork, hard work and a clear vision for the future.

Question: What are UW Medicine’s current goals?

Dr. Ramsey: We are in a very exciting and challenging time in medicine. UW Medicine’s primary goals relate to our mission of improving health for all people. It is important for UW Medicine, as a leading healthcare and academic system, to remain focused on improving the quality and safety of care and the overall services to patients and their families. At the same time, substantially controlling and reducing costs in the same areas are important.

Our goals this year encompass our mission of improving health in the work we do – in research to discover new ways to improve health, in our clinical programs by offering the very best care for our patients, and in our education and training programs designed to prepare the next generation of health and science professionals.

Q: How do you go about achieving your goals?

PR: As we focus on improving quality and safety in patient care while improving our services, we use measurement tools to assess where we are now, to monitor our progress, and to set goals for making improvements for the coming year.

Our research, supported primarily by grants, is oriented toward improving health. For educational programs, we establish measures and benchmarks to track outcomes, such as where our medical students and residents choose to practice after training, what percentage go into primary care, and how many students and residents choose practice settings that care for underserved patient populations. Metrics and measurements help us identify and support effective programs and improve our outcomes.

One excellent example of our use of measurement in clinical care is the work done over the past few years in the UW Medicine spine program – Sports, Spine & Orthopaedic Health. This program has integrated activities related to diagnoses and care of patients with back pain. Health professionals from multiple specialties – rehabilitation medicine, orthopedics, neurology, neurosurgery and radiology – have examined best practices in the literature and reviewed results from our own program to develop clinical pathways that are more standardized and cost-effective approaches to managing the very large number of patients with back pain.

As a result of this research and the resulting changes to our care approaches – as well as the outstanding service offered to patients – patients are very satisfied with our spine program. We know this because we ask patients to self-assess their recovery. By continuously using metrics and measurements to document and monitor program results, UW Medicine can apply for funding that furthers the system’s ability to improve patient care.

Q: In your opinion, are there any challenges UW Medicine faces in achieving its goals?

PR: There are major challenges in 2012. Our largest challenges, however, are common to all academic health systems around the United States. The foremost challenge is the economy.

The economy is adversely affecting support for medical education, clinical care and research. The negative impact on research comes at a time when research has done so much and could do so much more. It is frustrating to see medical research support decline when the outcomes are so exciting and are directly leading to improved health. In 2012, we have the potential to cure and prevent diseases in many areas that could not be addressed in the past. Just this past year, one of our researchers – Suzanne Craft – tested a nasal insulin spray as a treatment for memory loss and dementia. In a randomized controlled trial, she found significant improvement in patients who used the spray. Without adequate research funding, this very promising discovery will not be translated rapidly into new, cost-effective approaches for treatment. Funding support from the National Institutes of Health is extraordinarily important.

Another challenge common to all systems, including UW Medicine, is the fact that we must control healthcare costs and in some areas reduce costs rather dramatically while also improving quality, safety and access for patients. A business model of “we must do better” comes at the same time that we must control and reduce healthcare costs.

Fortunately, UW Medicine has a large number of hard-working, dedicated and outstanding people, who are working to improve quality, safety, service and access in all of our clinical settings.

Q: What do you believe has helped UW Medicine thrive despite hard economic times and downward pressure on the healthcare sector?

PR: We are financially stable across our very large health system, and I attribute our fiscal stability to hard work by hundreds of leaders across our system. We are fortunate to have a large number of individuals who are doing their jobs very well. We have also made substantial investments in our financial systems over the last five years, and these investments have resulted in accurate and timely financial information to enable us to make good decisions. UW Medicine has been historically conservative in developing business plans and that approach has served us well in a time of economic turmoil. In short, UW Medicine has thrived because of the outstanding, dedicated individuals who work here.

Q: What could other health systems learn from UW Medicine in terms of addressing current healthcare challenges?

PR: Since we are one of the largest and best health systems in the world, we have a special responsibility to develop solutions that other systems can emulate. We need to be a model for developing and implementing new approaches to treat and prevent diseases. Our leaders, faculty and staff are working to design new approaches to address clinical care – improvements for specific conditions, the best methods to implement known standards of care, and ways to increase the effectiveness of healthcare teams. We are also developing new approaches to using information technology that facilitate the work of our healthcare professionals and that help patients interact with their healthcare providers.

Q: What do you enjoy most about being CEO at UW Medicine?

PR: I enjoy all aspects of my position, but if you are asking me to identify one special area, I would say that it is the opportunity to shape the future of healthcare – to focus on how UW Medicine can advance its mission of improving health for all people. I enjoy leading, planning and developing new programs. I enjoy working with people and I am very fortunate to have a large number of outstanding administrative and academic leaders working with me. UW Medicine has more than 21,000 employees and we have culture of collaboration and teamwork. It is a great pleasure to follow all of the programs that are delivering excellence in patient care programs, creating new knowledge on a daily basis and preparing the next generation of healthcare professionals and scientists.

Q: What is your leadership philosophy?

PR: Lead by example. Lead by serving others. Lead by being an effective communicator. I try to support the individuals who are doing great work by working hard as well.

Q: What has been your proudest accomplishment as CEO?

PR: Despite the economic turmoil, UW Medicine has remained focused on improving health for all people, putting patients’ interests first and creating active learning for students and trainees. Despite the economy, UW Medicine has continued to achieve excellence in all of our activities.

Q: Do you have any personal goals for leading UW Medicine this year?

PR: My personal goals and aspirations align with UW Medicine’s goals. I receive great satisfaction from those goals because I value and enjoy UW’s overall mission of seeking to improve health for the overall population. I set my own professional goals in relationship to how I spend my time working with faculty, staff and students to achieve the overall goals for UW Medicine.

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Amalaki Review – The Convenience

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1. Amalaki – is the most powerful and most effective health restorer. In itself is the Great Rejuvenator. It promotes dramatic cellular health and production. It enhances energy levels and youthful vitality.

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